MEDICARE: GRANITE POINTE PSYCHIATRY GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1487484739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRANITE POINTE PSYCHIATRY GROUP, INC.

Provider Business Mailing Address
First Line	:	4120 DOUGLAS BLVD # 306-341
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-5936
Country	:	US
Telephone Number	:	916-695-9131
Fax Number	:

Provider Business Practice Location Address
First Line	:	9700 VILLAGE CENTER DR STE 111
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-6313
Country	:	US
Telephone Number	:	916-695-9131
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ELENA RAPOPORT
Credential	:	MD
Telephone Number	:	916-695-9131

Provider Enumeration Date	:	08/02/2024
Last Update Date	:	12/02/2025

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